Sharps are one of the most hazardous categories of waste generated in health care facilities. Injections are responsible for the generation of the largest quantity of infectious sharps generated during both immunization and curative practices. Due to the risks associated with sharps it is very important to manage them properly and to ensure they remain safe to the health care workers and the community at large. The present study documents successful sharps management systems in urban areas and evaluates non-burn treatment and disposal technologies. The study evaluated the coherence of these technologies with the current regulatory health care waste management (HCWM) framework in India. Due to the nation-wide introduction of auto disable (AD) syringes for immunization programmes, the study also analyses the implications linked to their use and the possibilities of material recovery of these syringes. The findings of the study indicate that it is of paramount importance to contain the infectious sharps in puncture-resistant containers, and to disinfect and mutilate them at point of generation to ensure the safety of the health care workers and the community at large. The use of alternative treatment and disposal technologies covered in the 13 success stories include needle cutters, chemical disinfection, autoclaving, microwaving, advanced autoclave like "Hydroclave", cement encapsulation and sharps pit. Health care institutions are satisfied with the technologies and felt that mutilation after disinfection was the most effective technique to ensure that infectious sharps are not re-used. Currently, the methods used for final disposal of sharps are not found to be sustainable. Health care workers felt that it was important to look into the option of material recovery from the injection units. The concept of AD syringes was new to many health care workers and they felt that AD syringes would be very useful during immunization programmes, as it would make sure that the sharps are not re-used. However, the health care workers felt that more research needs to be carried out in identifying the treatment and sustainable final disposal options of AD syringes before these are introduced throughout the country. Recommendations for the future in the field of sharps management are also presented.